Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY26569 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY26569 | CA |
NPI | 1003329830 |
---|---|
Provider Name | Dr. Andrea Samuels |
First Address | San Francisco, CA 94115-2532 |
Second Address | San Francisco, CA 94115-2532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2017 |
Last Update Date | 15/11/2017 |